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� ' �' CITY OF ORONO � <br /> 2750 KELLEY PARKWAY * 2 � 1 5 - 0 1 3 5 7 * <br /> DATE ISSUED: 10/2]/2015 <br /> ORONO,MN 55356- <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2024 SHADYWOOD RD <br /> PIN : 17-117-23-31-0011 <br /> LEGAL DESC : GUST S JOHNSONS ADDN <br /> : LOT 004 BLOCK 000 <br /> PERMIT TYPE : ESCROW FEE-APPLICANT <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : ESCROW FEE-APPLICANT <br /> NOTE: THIS 52500 ESCROW IS TIED TO ZONING PERMIT APPLICATION#15-3792 <br /> APPLICANT ESCROW FEE-APPLICANT 2,500.00 <br /> KIEFFER,JOHN&BENJAMIN Payment(s) TOTAL 2,500.00 <br /> 2024 SHADYWOOD RD CHECK 5272 2,500.00 <br /> WAYZATA,MN 55391- <br /> OWNER <br /> KIEFFER,JOHN&BENJAMIN <br /> 2024 SHADYWOOD RD <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed ac�tding to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. 1'his permit is for only the work described and does <br /> not gant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This permit wiil <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended fo�a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> / / <br /> Applicant Permrtee Stgnature Date Issued By Signature Date <br />